TY - JOUR
T1 - Longitudinal monitoring of sewershed resistomes in socioeconomically diverse urban neighborhoods
AU - Lee, Jangwoo
AU - Xiang, Kevin
AU - Au, Emily
AU - Sarabi, Shahrzad
AU - Acosta, Nicole
AU - Bhatnagar, Srijak
AU - Van Doorn, Jennifer
AU - Bertazzon, Stefania
AU - Conly, John M.
AU - Rennert-May, Elissa
AU - Pitout, Johann D.D.
AU - Lee, Bonita E.
AU - Pang, Xiaoli
AU - O’Grady, Christine
AU - Frankowski, Kevin
AU - Hubert, Casey R.J.
AU - Parkins, Michael D.
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Understanding factors associated with antimicrobial resistance (AMR) distribution across populations is a necessary step in planning mitigation measures. While associations between AMR and socioeconomic-status (SES), including employment and education have been increasingly recognized in low- and middle-income settings, connections are less clear in high-income countries where SES remains an important influence on other health outcomes. Methods: We explored the relationship between SES and AMR in Calgary, Canada using spatially-resolved wastewater-based surveillance of resistomes detected by metagenomics across eight socio-economically diverse urban neighborhoods. Resistomes were established by shotgun-sequencing of wastewater pellets, and qPCR of targeted-AMR genes. SES status was established using 2021 Canadian census data. Conducting this comparison during the height of COVID-related international travel restrictions (Dec. 2020–Oct. 2021) allowed the hypotheses linking SES and AMR to be assessed with limited confounding. These were compared with sewage metagenomes from 244 cities around the world, linked with Human Development Index (HDI). Results: Wastewater metagenomes from Calgary’s socioeconomically diverse neighborhoods exhibit highly similar resistomes, with no quantitative differences (p > 0.05), low Bray-Curtis dissimilarity, and no significant correlations with SES. By comparison, dissimilarity is observed between globally-sourced resistomes (p < 0.05), underscoring the homogeneity of resistomes in Calgary’s sub-populations. The analysis of globally-sourced resistomes alongside Calgary’s resistome further reveals lower AMR burden in Calgary relative to other cities around the world. This is particularly pronounced for the most clinically-relevant AMR genes (e.g., beta-lactamases, macrolide-lincosamide-streptogramin). Conclusions: This work showcases the effectiveness of inclusive and comprehensive wastewater-based surveillance for exploring the interplay between SES and AMR.
AB - Background: Understanding factors associated with antimicrobial resistance (AMR) distribution across populations is a necessary step in planning mitigation measures. While associations between AMR and socioeconomic-status (SES), including employment and education have been increasingly recognized in low- and middle-income settings, connections are less clear in high-income countries where SES remains an important influence on other health outcomes. Methods: We explored the relationship between SES and AMR in Calgary, Canada using spatially-resolved wastewater-based surveillance of resistomes detected by metagenomics across eight socio-economically diverse urban neighborhoods. Resistomes were established by shotgun-sequencing of wastewater pellets, and qPCR of targeted-AMR genes. SES status was established using 2021 Canadian census data. Conducting this comparison during the height of COVID-related international travel restrictions (Dec. 2020–Oct. 2021) allowed the hypotheses linking SES and AMR to be assessed with limited confounding. These were compared with sewage metagenomes from 244 cities around the world, linked with Human Development Index (HDI). Results: Wastewater metagenomes from Calgary’s socioeconomically diverse neighborhoods exhibit highly similar resistomes, with no quantitative differences (p > 0.05), low Bray-Curtis dissimilarity, and no significant correlations with SES. By comparison, dissimilarity is observed between globally-sourced resistomes (p < 0.05), underscoring the homogeneity of resistomes in Calgary’s sub-populations. The analysis of globally-sourced resistomes alongside Calgary’s resistome further reveals lower AMR burden in Calgary relative to other cities around the world. This is particularly pronounced for the most clinically-relevant AMR genes (e.g., beta-lactamases, macrolide-lincosamide-streptogramin). Conclusions: This work showcases the effectiveness of inclusive and comprehensive wastewater-based surveillance for exploring the interplay between SES and AMR.
UR - http://www.scopus.com/inward/record.url?scp=85214381412&partnerID=8YFLogxK
U2 - 10.1038/s43856-024-00729-y
DO - 10.1038/s43856-024-00729-y
M3 - Journal Article
AN - SCOPUS:85214381412
VL - 5
JO - Communications Medicine
JF - Communications Medicine
IS - 1
M1 - 7
ER -
